SLE 2005

COLLECTED AND TRIED TO BE ANSWERD AND SENT BY

DR.ABULMALIK ALBAKER 2011
MED_ST99@HOTMAIL.COM
- For health education programs to be successful all are true
except :
a- human behavior must be well understood
b- Information should be from cultural background
c- Doctors are only the health educators
d- Methods include pictures and videos (mass media)
e- Involve society members at early stage
- a 29 yrs. Old female has a breast lump in the upper outer
quadrant of the left breast , firm , 2 cm. in size but no L.N
involvement what is the most likely diagnosis ?
a- fibroadenoma
- What is the management for the above patient?
a- mammogram (true if patient > 35 years)
b- excisional biopsy
c- FNA
d- breast US
e- follow up in 6 months

- a 27 yrs. old female C/O abdominal pain initially periumbilical

then moved to Rt. Lower quadrant she was C/O
anorexia,nausea and vomiting as well ..

O/E : temp.38c , cough , tenderness in Rt lower quadrant but no

rebound tenderness.
Investigations : slight elevation of WBC's otherwise insignificant ..
The best way of management is:
a- go to home and come after 24 hours
b- admission and observation
c- further lab investigations
d- start wide spectrum antibiotic
e- paracetamol
- what is the most likely diagnosis for the above patient ?
a- mesenteric lymph adenitits
b- acute appendicitis
c- peptic ulcer
- a 24 yrs old pt. came for check up after a promiscuous relation 1
month ago .. he was clinically unremarkable, VDRL : 1/128 he
was allergic 2 penicillin other line of management is :
a- ampicillin
b- amoxicillin
c- trimethoprim
d- doxycyclin

- a 24 years old female pt. C/O : gray greenish discharge ,

itching .. microscopic examination of discharge showed :
flagellated organism most likely diagnosis is :
a- trichomoniasis ( trichomonas vaganalis )
- a 43 yrs. old female pt. presented to ER with H/O : paralysis of
both lower limbs and parasthesia in both upper limbs since 2
hours ago .. she was seen lying on stretcher & unable to move her

lower limbs (neurologist was called but he couldn't relate her

clinical findings 2 any medical disease !!! ) when history was
taken , she was beaten by her husband the most likely
diagnosis is :
a- complicated anxiety disorder
b- somatization disorder
c- conversion disorder
d- psychogenic paralysis
e- hypochondriasis
- the best treatment for the previous case is :
a- benzodiazepines
b- phenothiazine
c- monoamine oxidase inhibitor
d- selective serotonin reuptake inhibitor
e- supportive psychotherapy
- a 58 yrs. old male pt. came with HX of fever, cough with
purulent foul smelling sputum and CXR showed : fluid filled
cavity the most likely diagnosis is :
a- abscess
b- TB
c- bronchieactesis
- a 28 yrs. old lady , C/O: chest pain, breathlessness and feeling
that she'll die soon .. O/E : just slight tachycardia .. otherwise
unremarkable .. the most likely diagnosis is:
a- panic disorder

- a patient ( known case of DM ) presented to u with diabetic foot (

infection) the antibiotic combination is :
a- ciprofloxacin & metronedazole

- a young pregnant lady (Primigravida) , 32 weeks of gestation

came to you C/O : lower limbs swelling for two weeks duration ..
she went to another hospital and she was prescribed ( thiazide &
loop diuretic ) .. O/E : BP : 120/70 , mild edema , urine dipstick :
-ve and otherwise normal. The best action is :
a- continue thiazide & stop loop diuretic
b- cont. loop diuretic & stop thiazide
c- stop both
d- continue both and add potassium sparing diuretic
e- cont. both & add potassium supplement
- a 17 yrs. old football player gave HX of Lt. knee giving off .. the
most likely diagnosis is :
a- Lat. Menisceal injury
b- medial menisceal injury
c- lateral collateral ligament
d- medial collateral ligament
e ant. Curciate ligament
- a 10 yrs. old boy presented to clinic with 3 weeks HX of limping
that worsen in the morning .. this suggests which of the following :
a- septic arthritis
b-leg calve parthes disease
c- RA
d- a tumor
e- slipped capital femoral epiphysis
- a full term baby boy brought by his mother weighing 3.8 kg.
developed jaundice at 2nd day of life .. coomb's test ve ,Hb : 18
,billrubin : 18.9 & indirect : 18.4
O/E : baby was healthy and feeding well .. the most likely
diagnosis is :

a- physiological jaundice
b- ABO incompatibility
c- breast milk jaundice
d- undiscovered neonatal sepsis
- a 62 yrs. old female pt. a known case of osteoporosis & on 1
alpha + Ca supplement .. her lab works shows normal level of
PO4, Ca & ALP her X-ray shows osteopenia with SD = -3.5 .
The best action is to :
a- continue on same medications
b- start estrogen
c- start estrogen & progesterone
d-add alevdonate ( bisthmus phosphate)

- a 38 yrs old female came to you at your office and her pap
smear report was unsatisfactory for evaluation .. the best action
is :
a- consider it normal & D/C the pt.
b- Repeat it immediately
c- Repeat it as soon as possible
d- Repeat it after 6 months if considered low risk
e- Repeat it after 1 year if no risk
- a 17 yrs. old school boy was playing foot ball and he was kicked
in his Rt. eye .. few hours later he started to complain of : double
vision & echymoses around the eye .. the most likely Dx. Is :
a- cellulites
b- orbital bone fracture
c- global eye ball rupture
e- subconguctival hemorrhage

- a 35 yrs old female pt. C/O : acute inflammation and pain in her
Lt. eye since 2 days .. she gave Hx of visual blurring and use of
contact lens as well O/E : fluorescence stain shows dentritic
ulcer at the center of the cornea .. the most likely diagnosis is :
a- corneal abrasion
b- herpetic central ulcer
c- central lens stress ulcer
d- acute episcleritis
e- acute angle closure glaucoma

- a 65 yrs old lady came to your clinic with Hx of 5 days insomnia

and crying ( since her husband died ) the best Tx. For her is :
a- lorazipam
b- floxitein
c- chlorpromazine
d- haloperidol
- a 25 yrs old Saudi man presented with Hx of mild icterus ,
otherwise ok .. hepatitis screen : HBsAg +ve , HBeAg +ve , anti
HBc Ag +ve (this should be core anti body, because core antigen
doesnt leave hepatocyte to the blood "prof. Yasawi" ) , the
diagnosis :
a- acute hepatitis B
b- convalescent stage of hep. B
c- recovery with seroconversion Hep . B
d- Hep B carrier
e- chronic active Hep. B
- 25 yrs. old man presented to ur clinic with one month HX of
aching pain in the elbow , radiates down to the lateral forearm
..the pt. frequently plays squash O/E:

Pain increases with dorsiflexion of the wrist performed under

resistance specially with elbow extended the most likely
diagnosis :
a- olecranon stress fracture
b- olecranon bursitis
c- lateral tennis elbow
e- radial tunnel syndrome
e- ligament sprain
Special thanks to Dr.Fahad Abdul Jabbar & his colleague in King
Abdul Aziz University
- 8 wk Primigravida came to you with nausea & vomiting choose
the statement that guide you to hyperemmesis gravidarm :
a- ketonia
b- ECG evidence of hypokalemia
c- Metabolic acidosis
d- Elevated liver enzyme
e- Jaundice
Laboratory findings include ketonuria, increased urine specific gravity, elevated
hematocrit and BUN level , Hyponatremia ,Hypokalemia , Hypochloremia
,Metabolic alkalosis

Special thanks to Dr. Khalid Al-Qurashi KFU

- Injury of the hand leads to median nerve injury:
a- claw hand
b- wrist drop
c- sensory defect only
d- inability to oppose thumb
- 60 year old male was refer to you after stabilization investigation
show
Hgb 8,5 g/l , hect. 64% , RBC 7.8 , WBC 15.3
& Plt. 570 Diagnosis :
a- iron def. Anemia
b- Hgb pathy
c- CLL ??????????????
d- 2ry polycythemia

e- Polycythemia rubra Vera

- Pregnant women G4P3+1 on GA 10 wk came to you with IUCD
inserted & the string is out from O.S what is the most important
measure :
a- leave the IUCD & give A.B
b- leave the IUCD & send to Ob/ Gynaecologist to remove
c- leave the IUCD
d- do laparoscopy to see if there is ectopic preg.
e- Reassurance the pt
done by Dr. Khalid Shahat KFU
- 17 year old male while play football felt on his knee tern over
what do think the injury happened
abcde-

medial meniscus lig,

Lateral meniscus lig.
Medial collateral lig.
Lat. collateral lig.
Antr. Crussate lig.

Special thanks to Dr. Rizg Al-amri KFU

- For health education programme to be effective all true except :
a- Human behaviour should be well understood.
b- Procedures used include illustration & picture.
c- Doctors should be the only educator.
d- Community member should be involved in early stage.
e- .
Special thanks to Dr. Abdulmonem Al-hussain
- Placenta previa excludes :
a- Pain less vaginal bleeding
b- Tone increased of uterus
c- Lower segmental abnormality
d- Early 3rd trimester
- Pregnancy test +ve after :

abcd-

one day post coital

10 day after loss menstrual cycle ??
One wk after loss menstrual cycle
+ve 1 week before the expected menstruation .

Special thanks to Dr. Soud Al-Shalowi KFU

- 45 year old female complaining of itching in genitalia for certain
period, a febrile, -ve PMH, living happily with here husband since
20 year ago on examination no abdominal tenderness , erythema
on lower vagina , mild Gray discharge no hx of UTI .
pyleonephritis ,, Most probable diagnosis:
a- Vaginitis

b- Cystitis
c- CA of vagina
d- Urithritis ( non gonococal )
Special thanks to Dr. Faisl Battwil KFU
- 20 year lady come to ER with Hx of Rt sever lower abdominal
pain with Hx of amenorrhea for about 6 wk the most serious
diagnosis of your deff. Diagnosis could reach by:
abcde-

CBC
ESR
U/S of the pelvis
Plain X-ray
Vaginal swab for C/S

Special thanks to Dr. Ali Al-Khathami

- Pt had arthritis in two large joint & pansystolic murmur ( carditis
)
Hx of URTI the most important next step:
a- ESR
b- ASO titre
c- Blood culture

Duke Criteria for the Diagnosis of Endocarditis :

Major :
- At least two separate blood cultures for a typical organism, persistent
bacteremia with any organism, or a single culture of Coxiella burnetii.
- Evidence of endocardial involvement (via transesophageal echocardiography
or new murmur).
Minor
-Predisposing risk factors.
-Fever 38.3C.
-Vascular phenomena: Septic emboli, septic infarcts, mycotic aneurysm,
-Janeway lesions.
-Immunologic phenomena: Glomerulonephritis, Oslers nodes. Roths spots.
-Microbiological evidence that does not meet major criteria.

- 35 years prime 16 wk gestation PMH coming for her 1st cheek up

she is excited about her pregnancy no hx of any previous disease.
Her B/P after since rest 160/100 after one wk her B/P is 154/96
Most likely diagnosis :
abcde-

Pre eclempsia ( 20 )
Chronic HTN
Lable HTN
Chronic HPT with superimposed pre eclampsia
Transit HPT??

Special thanks to Dr. Hamza Qtrangy

- women complain of non fluctuated tender cyst for the vulva .
came pain in coitus & walking , diagnosed Bartholin cyst . what is
the ttt:
abcd-

incision & drainage

refer to the surgery to excision (after you reassure her)
reassurance the pt
give AB

Medical treatment of Bartholin's gland abscesses(They are located at the 5 o'clock and 7
o'clock positions on the hymenal ring ) was described earlier. If medical therapy fails,
surgical treatment of Bartholin's gland abscesses may include incision and drainage,
marsupialization, or in case of recurrence, resection of the gland.

Special thanks to Dr. Naif Al-Qahtani

- 42years old male presented with history of sudden appearance of

rash
maculopapular rash including the sole,& the palm,
the most likely diagnosis is :
asyphilis
b- erethyma nodosum
c- erythema marginatum
d- pitryasis rocae
e- drug induced
Special thanks to Dr.Mai
- A mother calls you about her 8 years old son , known case of
DM-1 fell comatose . she is not sure if he took the night 7 morning
dose of insulin. You will advice her to :
a- bring the child immediately to the ER
b- call an ambulance
c- give him IV glucagons (of course IV glucagons is first
d- give him IV insulin
then ER, but Q doesnt indicate
e- give him drink contains sugar
????
that the
mother can do it!!)
Special thanks to Dr. Reem
- years old lady on .., feels dizzy on standing, resolves after
10-15 minutes on sitting, decrease on standing, most likely she is
having :
a- orthostatic hypotension
b Special thanks to Dr.Fatima
- what is the most appropriate treatment for the above patient :
a- antiemetic
b- antihistamine
c- change the antidepressant to SSRI
d- thiazide diuretics
e- audiometry

 Special thanks to Dr.Nada

- 23 years old lady with one month history of nasal discharge &
nasal obstruction, she complained of pain on the face, throbbing
in nature , referred to the supraorbital area, worsen by head
movement, walking,& stopping. On - -- --------- examination ,
tender antrum with failure of transillumination ( not clear ), the
most likely the diagnosis is:
a- frontal sinusitis (we can NOT trannsiiluminate it)
b- maxillary sinusitis
c- dental abscess
d- chronic atrophic rhinitis
e- chronic sinusitis
Special thanks to Dr.Dua'a

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Collected & organized by Dr. Khalid Shahat

Dr.khalid.s@hotmail.com
COLLECTED AND TRIED TO BE ANSWERD AND SENT BY
DR.ABULMALIK ALBAKER
MED_ST99@HOTMAIL.COM